Young offenders in forensic institutions in the Netherlands after committing serious crimes: Contribution of mandatory treatment and reduction of reincarceration.

BACKGROUND: In the Netherlands, young offenders who have been convicted of a particularly serious offence may be subjected to a so-called 'Placement in an Institution for Juveniles' (PIJ) measure if they are considered to pose a high ongoing risk to public safety. They form a rarely studied distinct group. Treatment in specialist forensic custodial institutions for young people (FYCI) is an intervention of last resort and costly. The most serious young offenders tend to be the hardest to rehabilitate while preventing further offending. Treatment is focussed on reducing risk of harm as well as improving health and other protective factors. AIMS: To explore the contribution of treatment in an FYCI under a forensic treatment order-the PIJ-measure-to the reduction of risk of reoffending. METHODS: In a pre-post intervention study, the Juvenile Forensic Profile (JFP) was used to score complete case files of 178 young offenders at the start and end of their placement in an FYCI under the PIJ-measure, 59% of those serving between the years 2013 and 2016 inclusive. The JFP covers risk and protective factors in seven domains encompassing criminal behaviour, family, environment, risk factors, psychopathology, psychology and behaviour during incarceration. Change or stability in scores was tested against reincarceration within 2 years of PIJ-measure completion. RESULTS: Impulse control and alcohol and drug use problems showed the greatest improvements. Behaviour that deteriorates during the stay is primarily related to obtaining more autonomy during reintegration efforts, including furlough. Reincarceration in the 2 years of community follow-up was unusual (13.5%). The two main variables associated with reincarceration were problematic behaviour during the pre-discharge year and lack of behavioural improvement during treatment. CONCLUSIONS: Outcomes of mandatory treatment in this group of serious young offenders have not previously been studied in a rigorous pre-post intervention study design. We found evidence of an overall tendency to improvement over time in mental state and social skills, reflected by risk assessment scale scores. Continued substance use problems while incarcerated and continuing social skills deficits were most strongly associated with reincarceration suggests a possible need for review of these areas in the PIJ-measure programme. Results contribute to knowledge about risk assessment, treatment and preventions of harms by serious young offenders and may inform evidence-based policies and practices in the Netherlands and beyond.

Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: results of a 24-year longitudinal study.

OBJECTIVE: Childhood externalizing behavior is found to be relatively persistent. Developmental pathways within types of externalizing behavior have been recognized from childhood to adolescence. We aimed to describe the prediction of adult DSM-IV disorders from developmental trajectories of externalizing behavior over a period of 24 years on a longitudinal multiple birth cohort study of 2,076 children. This has not been examined yet. METHODS: Trajectories of the four externalizing behavior types aggression, opposition, property violations, and status violations were determined separately through latent class growth analysis (LCGA) using data of five waves, covering ages 4-18 years. Psychiatric disorders of 1,399 adults were assessed with the CIDI. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric disorders. RESULTS: All externalizing behavior types showed significant associations with disruptive disorder in adulthood. In all antisocial behavior types high-level trajectories showed the highest probability for predicting adult disorders. Particularly the status violations cluster predicted many disorders in adulthood. The trajectories most often predicted disruptive disorders in adulthood, but predicted also anxiety, mood, and substance use disorders. CONCLUSIONS: We can conclude that an elevated level of externalizing behavior in childhood has impact on the long-term outcome, regardless of the developmental course of externalizing behavior. Furthermore, different types of externalizing behavior (i.e., aggression, opposition, property violations, and status violations) were related to different adult outcomes, and children and adolescents with externalizing behavior of the status violations subtype were most likely to be affected in adulthood.

Children's problems predict adults' DSM-IV disorders across 24 years.

OBJECTIVE: The goal of this study was to determine continuities of a broad range of psychopathology from childhood into middle adulthood in a general population sample across a 24-year follow-up. METHOD: In 1983, parent ratings of children's problems were collected with the Child Behavior Checklist (CBCL) in a general population sample of 2,076 children and young adolescents aged 4 to 16 years. In 2007, 24 years later, 1,339 of these individuals were reassessed with the CIDI, a standardized DSM-IV interview. We used univariate logistic regression analyses to determine the associations between children's problems and adults' psychiatric disorders. RESULTS: Parent reported total problems scores in the deviant range (>85th percentile) predicted disruptive disorders in adulthood (odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.1-2.8). Adjusted for sex, age, and socioeconomic status in all analyses, deviant levels of parent-reported childhood anxiety predicted anxiety disorders in middle adulthood (OR = 1.6, 95% CI = 1.0-2.5). Conduct problems (i.e., cruelty to animals, lies) predicted both mood disorders (OR = 2.3, 95% CI = 1.1-4.8) and disruptive disorders (OR 2.1, 95% CI = 1.3-3.4), whereas oppositional defiant problems predicted only mood disorders (OR = 2.3, 95% CI = 1.0-5.2). Attention-deficit/hyperactivity problems did not predict any of the DSM-IV disorders in adulthood (OR = 0.8, 95% CI = 0.5-1.2). CONCLUSIONS: Children with psychopathology are at greater risk for meeting criteria for DSM-IV diagnoses in adulthood than children without psychopathology, even after 24 years. Moreover, different types of continuities of children's psychopathology exist across the lifespan. We found that anxious children, oppositional defiant children, and children with conduct problems are at greater risk for adult psychopathology. Effective identification and treatment of children with these problems may reduce long-term continuity of psychopathology.

Predicting adult emotional and behavioral problems from externalizing problem trajectories in a 24-year longitudinal study.

The aim of this study was to examine the prediction of adult behavioral and emotional problems from developmental trajectories of externalizing behavior in a 24-years longitudinal population-based study of 2,076 children. The adult psychiatric outcome of these trajectories has not yet been examined. Trajectories of the four externalizing behavior types: aggression, opposition, property violations and status violations were determined separately through latent class growth analysis using data of five waves, covering ages 4-18 years. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric problems based on the Adult Self-Report. The developmental trajectories of the four types of externalizing behavior mostly predicted intrusive, aggressive and rule-breaking behavior in adulthood. Non-destructive behaviors in childhood such as opposition and status violations predict adult problems to a larger extent than destructive behaviors such as aggression and property violations. In general, children who develop through high-level trajectories are likely to suffer from both internalizing and externalizing problem behavior in adulthood, regardless the direction of change (i.e. increasing/decreasing/persisting) of the high-level trajectory. We can conclude that the level rather than the developmental change of externalizing behavior problems has a larger impact on adult outcome.

Intergenerational transmission of child problem behaviors: a longitudinal, population-based study.

OBJECTIVE: From a developmental perspective, it is important to know to what extent childhood problem behaviors are transmitted across generations. In a longitudinal community study, we compared child behavior of parents with the behavior of their offspring. Intergenerational transmission was investigated for a broad range of problem behaviors, including internalizing problems and externalizing behavior. Sex differences were investigated as well. METHOD: We compared Child Behavior Checklist scores of 4- to 16-year-old children (N = 271) from a community sample assessed in 1983 with Child Behavior Checklist scores of their 6- to 18-year-old offspring (N = 424) who were assessed in 2007. Multilevel modeling was used to test intergenerational associations. RESULTS: Most forms of problem behavior in children were predicted by the behavior of their parents as children. Parents' Internalizing, Externalizing, and Total Problem scores in childhood all predicted similar problems in their children. Sex differences were found for Delinquent Behavior: continuity was stronger in mothers than it was in fathers, and it was also stronger in sons than in daughters. CONCLUSIONS: The finding that child behavior continues across generations poses challenges in finding ways to prevent problems from being transmitted across generations.